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Severe attack of ulcerative colitis in children: retrospective clinical survey
A Barabino1, L Tegaldo, E Castellano
1Paediatric Gastroenterology, Pathology Department, Istituto G. Gaslin, for Children, Genoa, Italy. abarab@tin.it
Insights
Severe attacks of ulcerative colitis (UC) are common in children, affecting 40%. While some attacks resolve with medication, many require surgery, and long-term remission is uncertain for many pediatric UC patients.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Clinical Pediatrics
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease affecting children.
- Severe attacks of UC in pediatric patients present unique challenges in management and prognosis.
Purpose of the Study:
- To investigate the clinical characteristics, prevalence, and outcomes of severe attacks of ulcerative colitis in children.
- To identify potential predictors for severe UC attacks in pediatric populations.
Main Methods:
- A retrospective chart review was conducted on 37 children diagnosed with ulcerative colitis.
- Data collected included prevalence, risk factors, timing, and outcomes of severe UC attacks.
Main Results:
- Twenty severe attacks occurred in 15 of 37 patients (40% prevalence).
- Age and disease extent at diagnosis did not predict severe attacks.
- Approximately 50% of severe attacks required urgent surgery, while the other 50% resolved with medical treatment.
- Of those recovering from the first attack, 40% required colectomy, 40% achieved long-term remission, and 20% needed elective surgery or were lost to follow-up.
Conclusions:
- Severe ulcerative colitis attacks have a high prevalence in children.
- Medical treatment alone resolved about half of the severe attacks, but emergency surgery was necessary for the other half.
- Long-term outcomes for children experiencing severe UC attacks are variable, with a significant proportion requiring colectomy despite initial recovery.
Aim:
To obtain clinical data concerning severe attacks of ulcerative colitis in children.
Patients And Methods:
A retrospective chart review of 37 children with ulcerative colitis was carried out in order to assess the prevalence, risk factors, timing of presentation, and outcome of severe attacks of ulcerative colitis.
Results:
A total of 20 severe attacks occurred in 15 out of the 37 patients. No difference in the occurrence of severe attacks was detected in relation to age or disease extent at diagnosis. The mean interval between disease diagnosis and a severe attack was 9.1 months (range 0-30). Of the 20 severe attacks, 11 were resolved with medical treatment in a mean time of 1 1 +/- 4.6 days while 9 out of 20 needed urgent surgery in a mean time of 7.4 +/- 4.8 days. Of 10 out of the 15 patients who recovered from the first attack 4 required colectomy after a mean time of 6.7 months, another 4 are still in remission at a mean period of 40.7 months, one needed elective surgery after 25 months and one was lost to follow-up.
Conclusions:
Severe attacks of ulcerative colitis had a high prevalence rate [40%); age and disease extent at presentation were not predictors of their occurrence. Approximately half the attacks resolved with medical treatment alone, while the other half required emergency surgery. After successful medical treatment of the first attack, 40% of children maintained long-term remission, while 40% required early colectomy